Infecção pulmonar fatal por Lagochilascaris sp., provavelmente Lagochilascaris minor Leiper, 1909

É descrito um caso fatal de infecção por Lagochilascaris sp., — provavelmente Lagochilascaris minor Leiper, 1909 —, com localização pulmonar. O paciente, do sexo feminino, oriundo de Curralinho-Estado do Pará, desenvolveu uma pneumonite grave, que lhe acarretou a morte, por insuficiência respiratória, em pouco menos de três meses. À autópsia, numerosas lesões de natureza exsudativa e granulomatosa podiam ser vistas em ambos os pulmões, indicando tuberculose ou infecção micótica pulmonar. Todavia, quando se procedeu ao exame microscópico, ovos, larvas e até uma fêmea grávida do verme foram encontrados nos tecidos, como causa da doença — sempre no interior de granulomas ou de extensas áreas de necrose. Em quase todos os casos, até agora conhecidos, de lagoquilascaríase humana — cerca de 25 —, o parasito se localizava nos tecidos do pescoço, nos seios da face ou sobre a apófise mastóide. Neste caso, pela primeira vez, um representante do gênero Lagochilascaris é referido em sítio bem distinto do habitual, no hospedeiro humano. O achado, por outro lado, dos diferentes estádios evolutivos do helminto, dispersos pelo parênquima pulmonar, além de mostrar a natureza errática do parasitismo, sugere fortemente a existência de um ciclo pulmonar na lagoquilascaríase humana.

Lagochilascaris minor Leiper, 1909, (Nematoda-Ascaridae) de origem humana

Os autores isolaram e estudaram morfologicamente Lagochilascaris minor Leiper 1909, material obtido na cirurgia de um abscesso cervical direito de um menino de cor branca, com cinco anos de idade, procedente da cidade de Colorado, no Município de Vilhena, em Rondonia-Brasil. É sugerida uma chave para o diagnóstico diferencial das espécies do gênero Lagochilascaris.

Ação "in vitro" do Ivermectin sobre ovos de Lagochilascaris Minor leiper, 1909

Ovos uterinos de fêmeas L. minor, obtidos por eliminação espontânea de abscessos cervicais da paciente W. M. R. (Pequizeiro-GO) - foram postos em contato com solução de Ivermectin nas concentrações de 50, 100, 150, 200 e 250 microgramas. Os resultados demonstraram que a droga em todas as concentrações utilizadas não impediu o desenvolvimento larvário. Entretanto, decorrida a embriogênese houve um processo de desvitalização da larva no interior do ovo caracterizado pela liberação de uma massa amorfa a partir do ovo embrionado. Em ovos do grupo controle houve eclosão de uma larva íntegra com todas as características estruturais de larva de Lagochilascaris.

Infección inducida en el roedor selvático Dasyprocta leporina (Rodentia: Dasyproctidae), con huevos larvados de Lagochilascaris minor (Nematoda: Ascarididae)

Ejemplares de Dasyprocta leporina Linnaeus, 1758 fueron criados alejados de su ambiente natural. A los 3 ó 4 meses de edad, se los inoculó por vía oral con huevos de Lagochilascaris minor Leiper, 1909 obtenidos de una paciente nativa. Los huevos se los incubó por más de 80 dias, para que de ellos fuese posible obtener por compresión mecánica, larvas que se mantuviesen vivas en medio acuoso por 48 horas o más. Sacrificados los animales a los 14 ó 46 dias posteriores a la infección, se hallaron en los músculos esqueléticos larvas ovilladas dentro de nódulos inflamatorios, los cuales no presentaban reacción a cuerpo extraño, abscedación o calcificación. El desarollo de los nódulos no parecía afectar la normalidad de los hospedadores. Las larvas obtenidas eran similares a las descritas por SPRENT como de tercer estadio para estos helmintos. Ratones blancos infectados con material similar, no presentaron nódulos en sus músculos ni se pudo recuperar de sus tejidos larva alguna. Por los hallazgos obtenidos con la infección de estos animales, se postula que el helminto no posee ciclo pulmonar y que su desarrollo requiere de un hospedador intermediario.

Experimental life cycle of Lagochilascaris minor Leiper, 1909

The life cycle of Lagochilascaris minor was studied using material collected from human lesion and applying the experimental model: rodents (mice, hamsters), and carnivorae (cats, dogs). In mice given infective eggs, orally, hatch of the third stage larvae was noted in the gut wall, with migration to liver, lungs, skeletal musculature and subcutaneous tissue becoming, soon after, encysted. In cats infected with skinned carcasses of mice (60 to 235 days of infection) it was observed: hatch of third stage larvae from the nodules (cysts) in the stomach, migration through the oesophagus, pharynx, trachea, related tissues (rhino-oropharynx), and cervical lymphonodes developing to the mature stage in any of these sites on days 9-20 post inoculation (P.I.). There was no parasite development up to the mature stage in cats inoculated orally with infective eggs, which indicates that the life cycle of this parasite includes an obligatory intermediate host. In one of the cats (fed carcass of infected mice) necropsied on day 43 P.I., it was observed the occurence of the self-infective cycle of L. minor in the lung tissues and in the cervical region which was characterized by the finding of eggs in different stages of development, third stage larvae and mature worms. It's believed that some component of the carnivorae gastrointestinal tracts may preclude the development of third stage larvae from L. minor eggs what explains the interruption of the life cycle in animals fed infective eggs. It's also pointed out the role of the intermediate host in the first stages of the life cycle of this helminth.

Evaluation in white mice of the infectivity of egs of Lagochilascaris minor (Nematoda: ascarididae), incubated by decortication with sodium hypochlorite (NaOCl)

White mice were used to study the infectivity of the eggs of Lagochilascaris minor Leiper, 1909 after incubation in liquid media, with or without preservative substances. Potassium bichromate (K2Cr2O7) at 1% restrict hatching, while 1% formalin gave a greater larval yield. Incubation of eggs in distilled water, in Roux or Falcon flasks gave a good yield, whether the eggs were obtained from human feces or from experimentally infected cats. Treatment of eggs with Sodium hypochlorite (NaOCl) at 5.25% for 2 min prior to inoculation, produced a notable increment of the larval yield in the infections.

ASSESSMENT OF IVERMECTIN THERAPEUTIC EFFICACY ON THIRD-STAGE LARVAE OF Lagochilascaris minor IN MICE EXPERIMENTALLY INFECTED

In this study we evaluated the potential action of ivermectin on third-stage larvae, both at migratory and encysted phases, in mouse tissues after experimental infection with Lagochilascaris minor. Study groups I and II consisted of 120 mice that were orally administered 1,000 parasite eggs. In order to assess ivermectin action upon migratory larvae, group I (60 mice) was equally split in three subgroups, namely I-A, I-B, and I-C. On the 7th day after inoculation (DAI), each animal from the subgroup I-A was treated with 200 µg/Kg ivermectin while subgroup I-B was given 1,000 µg/Kg, both groups received a single subcutaneous dose. To assess the drug action on encysted larvae, group II was equally split in three subgroups, namely II-A, II-B, II-C. On the 45th DAI each animal was treated with ivermectin at 200 µg/Kg (subgroup II-A) and 1,000 µg/Kg (group II-B) with a single subcutaneous dose. Untreated animals of subgroups I-C and II-C were used as controls. On the 60th DAI all animals were submitted to larva search. At a dose of 1,000 µg/Kg the drug had 99.5% effectiveness on third-stage migratory larvae (subgroup I-B). Ivermectin efficacy was lower than 5% on third-stage encysted larvae for both doses as well as for migratory larvae treated with 200µg/Kg.

Lagochilascaris minor IN A PATIENT FROM THE COLOMBIAN AMAZON: A CASE REPORT

A chronic infection (10 years) by Lagochilascaris minor is described in a woman from the amazon region of Colombia. This is the third case of infection by this parasite that has been described so far in Colombia, and only the first one in a person coming from the Colombian Amazon region.

Fibrotic sequelae in pulmonary paracoccidioidomycosis: histopathological aspects in BALB/c mice infected with viable and non-viable Paracoccidioides brasiliensis propagules

Patients with paracoccidioidomycosis often present pulmonary fibrosis and exhibit important respiratory limitations. Based on an already established animal model, the contribution of viable and non-viable P. brasiliensis propagules to the development of fibrosis was investigated. BALB/c male mice, 4-6 weeks old were inoculated intranasally either with 4x10(6 )viable conidia (Group I), or 6.5x10(6) fragmented yeast cells (Group II). Control animals received PBS. Six mice per period were sacrificed at 24, 48, 72h (initial) and 1, 2, 4, 8, 12 and 16 weeks post-challenge (late). Paraffin embedded lungs were sectioned and stained with H&E, trichromic (Masson), reticulin and Grocott´s. During the initial period PMNs influx was important in both groups and acute inflammation involving 34% to 45% of the lungs was noticed. Later on, mononuclear cells predominated. In group I, the inflammation progressed and granulomas were formed and by the 12th week they fussed and became loose. Thick collagen I fibers were observed in 66.6% and 83.3% of the animals at 8 and 12 weeks, respectively. Collagen III, thick fibers became apparent in some animals at 4weeks and by 12 weeks, 83% of them exhibited alterations in the organization and thickness of these elements. In group II mice, this pattern was different with stepwise decrease in the number of inflammatory foci and lack of granulomas. Although initially most animals in this group had minor alterations in thin collagen I fibers, they disappeared by the 4th week. Results indicate that tissue response to fragmented yeast cells was transitory while viable conidia evoked a progressive inflammatory reaction leading to granuloma formation and to excess production and/or disarrangement of collagens I and III; the latter led to fibrosis.

Lagochilascaris minor Leiper, 1909 (Nematoda: Ascarididae) in Mexico: three clinical cases from the Peninsula of Yucatan

Human lagochilascariasis (HL) is a parasite produced by Lagochilascaris minor Leiper 1909 that also can be found in cats and dogs. HL is considered an emerging zoonosis in the Americas, spreading from Mexico to Argentina, and the Caribbean Islands. The present paper describes three HL cases from the Peninsula of Yucatan, Mexico, recorded in the last decade. It describes the characteristics of the lesions and discusses the route of transmission in humans and particularly in the observed patients.

EVALUATION OF THE THERAPEUTIC EFFICACY OF LEVAMISOLE HYDROCHLORIDE ON THIRD-STAGE LARVAE OF Lagochilascaris minor IN EXPERIMENTALLY INFECTED MICE

Lagochilascariosis, a disease caused by Lagochilascaris minor, affects the neck, sinuses, tonsils, lungs, the sacral region, dental alveoli, eyeballs and the central nervous system of humans. A cycle of autoinfection may occur in human host tissues characterized by the presence of eggs, larvae and adult worms. This peculiarity of the cycle hinders therapy, since there are no drugs that exhibit ovicidal, larvicidal and vermicidal activity. Given these facts, we studied the action of levamisole hydrochloride on third-stage larvae in the migration phase (G1) and on encysted larvae (G3) of L. minor. To this end, 87 inbred mice of the C57BL/6 strain were divided into test groups comprising 67 animals (G1-37; G3-30) and a control group (G2-10; G4-10) with 20 animals. Each animal was inoculated orally with 2,000 infective eggs of the parasite. The animals of the test groups were treated individually with a single oral dose of levamisole hydrochloride at a concentration of 0.075 mg. The drug was administered either 30 minutes prior to the parasite inoculation (G1 animals) or 120 days after the inoculation (G3 animals). The mice in the control groups were not treated with the drug. After the time required for the migration and the encysting of L. minor larvae, all the animals were euthanized and their tissues examined. The data were analyzed using the Student's unpaired t-test and the Levene test. The groups showed no statistically significant difference. Levamisole hydrochloride was ineffective on third-stage larvae of L. minor. These findings explain the massive expulsion of live adult worms, as well as the use of long treatment schemes, owing to the persistence of larvae and eggs in human parasitic lesions.

Avaliação da eficácia terapêutica da ivermectina sobre larvas de quarto estádio de Lagochilascaris minor em gatos infectados experimentalmente

Avaliou-se a ação da ivermectina sobre larvas de quarto estádio em gatos infectados experimentalmente com Lagochilascaris minor. Foram utilizados 30 gatos (divididos, igualmente, em três grupos I, II e III), sendo que cada animal foi inoculado, por via oral, com 50 larvas de terceiro estádio do parasito. Cada animal, dos grupos I e II, foi tratado com ivermectina na dosagen de 200mig/kg, no quinto dia após o inóculo (DAI). Os animais do grupo I foram examinados, clinicamente, entre 30 e 40 dias e os do grupo II entre 180 e 190 dias sendo, em seguida, submetidos à necropsia. Os dez animais do grupo III, não foram tratados com a droga constituindo o grupo controle. Independentemente do período de observação, observou-se 100% de eficácia da droga, visto que houve total interrupção do ciclo biológico do parasito em todos animais tratados. Todos animais do grupo controle desenvolveram a infecção por Lagochilascaris minor.

Lagochilascaris minor: antibody production in experimentally infected mice

Lagochilascaris minor is the causative agent of lagochilascariosis, a disease that affects the neck region and causes festering abscesses, with eggs, adult parasites and L3/L4 larvae within the purulent exudates. Today, mice are considered to be intermediate hosts for the parasite. C57BL/6 mice produce immunoglobulin IgM, IgA and IgG against the crude extract of the parasite; on the other hand, antibodies produced against the secreted/excreted antigens of Lagochilascaris minor present lower levels of IgM, IgA and IgG. This is the first description of antibody detection against different antigens of Lagochilascaris minor.

Brazil nuts: determination of natural elements and aflatoxin

A study was carried out to evaluate the association of levels of radioactivity, selenium and aflatoxin in shelled Brazil nuts, which were classified in different sizes, for export. The selenium determinations were performed by inductively coupled plasma optical emission spectrometry (LOQ = 3.0 µg g-1), and aflatoxins were detected by Liquid chromatography-mass spectrometry (LOQ = 0.85 µg kg-1), recovery rates were between 92 and 100%. Radioactivity was measured by high-resolution gamma spectrometry. The selenium mean concentration was (22.7 ± 7.4) µg g-1. (n = 30). Mean activities determined for the following radium isotopes were: 15.77 Bq kg-1 for 224Ra, 104.8 Bq kg-1 for 226Ra and 99.48 Bq kg-1 for 228Ra. For 226Ra, the levels did not vary significantly with nut sizes, although such differences were observed for 224Ra and 228Ra. There was no statistically significant association between the level of selenium and the activity of radionuclides, however, there was correlation between the radionuclides. Aflatoxins above the quantification limit were not found.

Considerações sobre os Thallosporados: o gênero Trichosporon: "Trichosporon minor" n. sp. produtor da piedra axilar

O autor estuda o gênero trichosporon, sob o ponto de vista da sistemática e como produtor da piedra branca e de micoses internas generalisadas do tipo gomoso. Estabelece a prioridade do termo Trichosporon, como foi descrito primeiramente, por BEHREND, devendo-se abandonar a designação posterior de Trichosporum, dada por VUILLEMIN. Estuda a distinção das duas piedras – a piedra branca ou trichosporica e a piedra negra ou asterinica. As lesões produzidas pelos dois cogumelos no pelo parasitado são consideradas como fator indispensável para a fixação do parasito no pêlo e para a formação ulterior no nódulo. Por iim descreve uma nova espécie de piedra, a piedra axilar, produzida pelo Trichosporon minor n. sp. Trichosporon minor n. sp. – cogumelo produtor da piedra axilar, formando nos cabelos desta região pequenos nódulos de coloração acinzentada, de consistência dura e tamanho variável e constituídos de células arredondadas, elíticas ou alongadas, medindo 0,5 a 4 μde diâmetro e algumas germulantes formando cadeias de dois a quatro elementos. Descola a epidermícula do cabelo, onde se fixa, sem entretanto penetrar nas camadas mais profundas. Nos meios artificiais de cultura dá colônias a princípio chatas de superfície húmida e aveludada com franjas espessas e salientes ou colônias vermiculares, ou culturas brancas, chatas, semelhantes a culturas de actinomyces. Não fermenta os açúcares; gelifica tardiamente a gelatina.